Circulating Ubiquitin Carboxyl Terminal Hydrolase L1 and Neuroglobin Levels in Traumatic Spinal Cord Injuries: Relation to Severity and Outcomes

Sawsan Abuhamdah; Tahia H Saleem; Bakheet E M Elsadek; Omyma Ashraf; Ali R Hamdan; Eslam El Sayed El-Khateeb; Saeda M Abd Elwahab; Mohammed H Hassan

doi:10.2147/IJGM.S364736

Circulating Ubiquitin Carboxyl Terminal Hydrolase L1 and Neuroglobin Levels in Traumatic Spinal Cord Injuries: Relation to Severity and Outcomes

Int J Gen Med. 2022 Jun 25:15:5795-5805. doi: 10.2147/IJGM.S364736. eCollection 2022.

Authors

Sawsan Abuhamdah^{1

2}, Tahia H Saleem³, Bakheet E M Elsadek⁴, Omyma Ashraf⁵, Ali R Hamdan⁶, Eslam El Sayed El-Khateeb⁶, Saeda M Abd Elwahab⁷, Mohammed H Hassan⁵

Affiliations

¹ College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.
² Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan.
³ Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt.
⁴ Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Al-Azhar University, Assiut, 71524, Egypt.
⁵ Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, 83523, Egypt.
⁶ Department of Neurosurgery, Faculty of Medicine, South Valley University, Qena, 83523, Egypt.
⁷ Radio-Diagnosis Department, Faculty of Medicine, South Valley University, Qena, 83523, Egypt.

Abstract

Introduction: Traumatic spinal cord injury (TSCI) is a life-threatening neurological disorder and there is a lack of biomarker research, particularly human studies that could help to categorize the severity and predict the outcome. We aimed to assess the role of serum Ubiquitin C-terminal hydrolase L1 (UCH-L1) and Neuroglobin (NGB) in predicting severity and outcome of TSCI.

Methods: This prospective study included 63 participants categorized into 33 patients with various types of TSCI and 30 unrelated healthy volunteers. Neurosurgical [American spinal injury association (ASIA) impairment score (AIS)] and radiological [using spine computed tomography (CT) and magnetic resonance imaging (MRI)] assessments were performed on the included patients to determine the severity and the level of injury with neurological follow-up of patients within 6 months post-injury. Serum UCH-L1 and NGB were measured for all participants using commercially available ELISA assay kits.

Results: Of the included patients, 20 (60.60%) had partial SCI and the remaining 13 patients (39.39%) had complete SCI. On follow-up, 19 patients (57.57%) showed improved AIS, while 14 cases (42.42%) did not show any improvement in their AIS scores. There was significantly higher median serum UCHL1 value among cases compared to controls (1723 pg/mL and 657 pg/mL, respectively), p ˂ 0.05. There was an insignificant rise of serum NGB levels among cases in comparison with the controls (15.2pg/mL and 7.52pg/mL, respectively, p ˃ 0.05). Significantly lower initial median serum UCHL1 levels (pg/mL) were observed in patients with improved AIS during the neurological follow-up compared with those who did not show any improvement in their AIS score (1723, and 4700 respectively, p ˂ 0.05), with lack of significant difference in the initial median serum NGB levels, p ˃ 0.05.

Conclusion: Initial serum UCHL1 assay could be a helpful marker in reflecting the degree of TSCI and predicting its outcome, though NGB needs further assessment.

Keywords: Ubiquitin C-terminal hydrolase L1; diagnostic and prognostic markers; neuroglobin; traumatic spinal cord injury.

Grants and funding

This study was partially funded by Faculty of Medicine, South Valley University, Qena 83523, Egypt.